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Objectives The aim of this study was to investigate which prepartum determinants contribute to the development of postpartum (PP) fatigue among working women in the Netherlands. Methods A prospective cohort study in 15 Dutch companies was conducted to measure different potential predictors using self-administrated questionnaires at baseline and at 30 weeks of pregnancy. Fatigue was measured at 12 (N = 523) and 52 weeks (N = 436) PP using the Checklist Individual Strength (CIS). A CIS score > 76 was defined as fatigue. Results The prevalence of fatigue at 12 and 52 weeks PP was 24.5% and 18.1%, respectively. Fourteen predictive factors were found for fatigue (R 2 = 0.37) at 12 weeks PP. Ten predictive factors were found for fatigue at 52 weeks PP (R 2 = 0.36). In general, less favourable work relationships and characteristics, poorer mental health, more passive coping styles, more sleeping problems, more fatigue during pregnancy, and beliefs about child care arrangements were related to PP fatigue. At 30 weeks of pregnancy, only more fatigue (OR = 3.69, p < 0.001; OR = 2.68, p = 0.02) and poorer mental health (OR = 0.50, p = 0.02; OR = 0.90, p = 0.78) predicted fatigue both at 12 and 52 weeks PP. Conclusions A large number of predictive factors for PP fatigue were found. These findings indicate that different aspects can contribute to being fatigued after pregnancy. Further research is needed to investigate the effect of possible interventions by employers and/or occupational physicians. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is considerable evidence that being involved in compensation processes has a negative impact on claimants’ health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants’ perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants’ quality of life. Method: Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life. Results: Participants (n =176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p <.001). The length of hospital stay was positively associated with procedural justice (β =.31, p <.001). Having trunk/back injury was negatively related to procedural justice (β =−.25, p =.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (r s =.22, p =.004). Discussion: The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants’ health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process. [Copyright &y& Elsevier]

Abstract: Background: Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health. Method: Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion. Results: Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=−0.38; 95% confidence interval (CI) −0.66 to −0.10; p =.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=−0.35; 95% CI −0.70 to −0.01; p =.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity. Discussion: Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health. [Copyright &y& Elsevier]

Abstract: Background: Injured people who are involved in compensation processes have less recovery and less well-being compared to those not involved in claims settlement procedures. This study investigated whether claim factors, such as no-fault versus common law claims, the number of independent medical assessments, and legal disputes, predict health care utilization after transport accidents. Method: The sample consisted of 68,911 claimants who lodged a compensation claim at the Transport Accident Commission (TAC) in Victoria, Australia, between 2000 and 2005. The main outcome measure was health care utilization, which was defined as the number of visits to health care providers (e.g. general practitioners, physiotherapists, psychologists) during the 5 year period post-accident. Results: After correction for gender, age, role in accident, injury type, and severity of injury, it was found that independent medical assessments were associated with greater health care utilization (β =.36, p <.001). Involvement in common law claims and legal disputes were both significantly related to health care utilization (respectively β =.05, p <.001 and β =−.02, p <.001), however, the standardized betas were negligible, therefore the effect is not clinically relevant. A model including claim factors predicted the number of health care visits significantly better (ΔR 2 =.08, p <.001) than a model including only gender, age, role in accident, injury type, and severity of injury. Conclusion: The positive association between the number of independent medical assessments and health care utilization after transport accidents may imply that numerous medical assessments have a negative effect on claimants’ health. However, further research is needed to determine a causal relationship. [Copyright &y& Elsevier]